NPIMap

Individual provider Active NPI

Savannah Lusk

  • Family Medicine Physician
  • Charleston, WV
National Provider Identifier
1134878499
Registry record updated Jan 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36010 Issued in WV
Practice address
303 Ohio Ave
Charleston, WV 25302-2212
Phone
(681) 205-8701
NPI assigned
Mar 22, 2022
Last updated
Jan 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36010 WV Primary

Addresses

Primary practice location

303 Ohio Ave
Charleston, WV 25302-2212

Mailing address

104 Alex LN
Charleston, WV 25304-2952
Phone (304) 734-2040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260214000836 WV Practitioner - Family Practice 6305326778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cabin Creek Health Center IncGroup PAC ID 2466431101, 41 clinicians

Practice addresses (Care Compare)

303 Ohio Ave
Charleston, WV 25302-2212
Phone 30473420401301

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36010WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cabin Creek Health Center, Inc. CurrentSince Jan 7, 2026 Accepting new patients
Cabin Creek Health Center, Inc. CurrentSince Jan 7, 2026 Accepting new patients

Locations

104 Alex Ln
Charleston, WV 25304
Phone 30473420401319

107 Koontz Ave
Ste 200
Clendenin, WV 25045
Phone (304) 548-7272

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767398400000",
    "number": "1134878499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 ALEX LN",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042952",
            "telephone_number": "304-734-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 OHIO AVE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253022212",
            "telephone_number": "681-205-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSK",
        "first_name": "SAVANNAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2026-01-03",
        "certification_date": "2026-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "36010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.